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thank you so much Vincent and thank you so much for inviting me this is one of my favorite topics to talk about besides being super important so being important and really enjoying talking about is a good good combination thank you so much for you know logging on and listening today and happy Pride Month as the clinical psychologist this is definitely a topic that I get a lot of questions about that I get to talk about a lot both with patients with parents but really increasingly as part of professional development efforts you know I do a lot of work with schools medical departments clinical programs sort of mental health professionals um and I think there's certainly a lot of work to be done as we'll talk about over the the next bit of time here but at the outset I do want to say that I do feel optimistic about sort the growing awareness that this is an important topic and we do need to be talking about sexual orientation and gender identity specifically in autism and that there's a good building of resources that we're seeing related to these topics so I think there's sort of cause for optimism which which is promising I think to me um so without further ado let's talk about why you're all here I'm gonna start with a brief thank you because I do sometimes feel like it gets squished towards the end first as to our participants so I'll be talking about the results of a study that we run first roundup in the fall we're opening up a second round the upcoming end of summer beginning of fall and then our research team which is made of a really good group of undergraduates and graduate students all across the neurodiversity spectrum for helping to run these studies and then as Vincent mentioned our Community Advisory Board and I want to highlight this group because this is a group that very kindly comes we have dinner we sit down we go through our research protocols we talk about what we're working on how we could improve those projects and what areas were really missing and that is a really huge part of our research program and how we develop these ideas I'm gonna think that's really important to share the effort that that team has put in with giving us feedback on our our work that cleanup of stakeholders like self-advocates parents at haters teachers and it's also a lot of fun so what are we going to talk about today we're going to talk about the gender unicorn if you have not met the gender unicorn get excited if you've already met the gender unicorn then a little review will kick off just to get some terms in place we'll talk specifically on gender identity and sexual orientation and sort of what there is to know within autism specifically we'll talk about sexuality and relationship education that's my other favorite thing to talk about I'll share a little bit of the data from our first round of data collection from that study I just mentioned I'm gonna leave you with some action steps and resources which is usually the part that people are really here for anyway so I'll make sure that we spend some good time on those two steps and then I'll save some time for questions at the end so feel free to type those in the chat and Vincent will help curate those for me so let's get started by getting everyone on the same page with some terms this is oftentimes a question that I get from people trying to lead these discussions like I don't want to say the wrong thing and there's so many terms so let's break it down just to make sure we're all approaching this in the same way okay B let's see if you can see my mouse over here I think you can so gender identity and gender expression are up at the top all right so this refers to your gender and how you think about yourself so gender identity as you can see from the rainbow and the little thought bubble here is how your your internal sense of gender how you think about your gender okay compared to your gender expression which are those green dots that go around the outside of the unicorn that is how you sort of present your gender and if you'll notice under each of these headings there are three arrows so for gender identity there's female woman girl and male man boy and then other genders okay so for your gender identity you can be any sort of a level along each of those three lines essentially so you could feel somewhere like sometimes female sometimes male you could feel that you're an other gender sort of a non-binary space that doesn't fall into those sort of prescribed buckets of being a girl or a boy and that might be similar to your gender expression but it also might not be right so that's where we find our gender identity terms and then below that we have sex assigned at birth and so you see the little DNA strand hanging over sort of the genital area so this is oftentimes when a baby is born and they pop out and the doctor notices they have a penis or they have vulva hey you have a girl or a boy right so that's what we considers for sex assigned at birth oftentimes this is consistent with the chromosomes that you have right so an XY chromosome pair or an X X chromosome pair however and this is always I think a fact that um people find a bit interesting 5 at least 5% of pregnancies have some sort of chromosomal combination other than that right so either people have um one of the chromosomes that you're expecting their sex chromosomes or they have more than two all right so that's five out of a hundred people so when we talk about sex assigned at birth it's not quite as rigid of binary as we might have thought of initially and sometimes people who go through their lives and not realize that they have just one or two or more than the two chromosomes but sometimes this comes up in other ways when you know people are going through puberty but just to be aware that sex assigned at birth is still not as clear a message as I think sometimes we are taught down at the bottom physically attracted and emotionally attracted to these are sexual orientation terms okay oftentimes and including in this talk gender identity and sexual orientation get clumped together but they're not really referring to the same things right sexual orientation is who we like right so who we might be sexually attracted to on this chart breaks it down into physically attracted to and emotionally attracted to right over the heart it's very sweet and then you can certainly be at different levels on all these like if you are only attracted to women physically and emotionally you might be all on those lines if you're bisexual might be split if it's the you know the gender of the person isn't particularly the part that like builds your attraction you might be on a different part of the spectrum and then also when we're talking about asexuality if you're just attraction to other people sexually physically emotionally is so you might just be low across all of those arrows yeah what I like about this tool is that obviously there's a lot of complexities around identity and how identity shifts over time and how we understand and recognize our own identity in the context of a culture but that it is a good thing to have up and posted right so if you're a provider have this in your office you know have it up on your fridge at home if you've got kids have it up in your classroom because if someone has a question then you've got some terms you can use and it really exposes kids from an early age this idea that there are a lot of differently is to think about gender and sexual orientation and it can be a good way to talk about I guess have a larger conversation about how we have these stereotypes of gender roles and how that even though we're sort of raised in this society that really reinforces those there might be some other ways to think about sexual orientation and gender the other thing that I really like about this tool is that a quick google brings us up at all sorts of languages right so if you are working with the community where you need a bunch of different languages ready to go at your fingertips that already exist for you on the Internet and we'll talk about some limits to the internet a little bit but they are out there okay so let's dig in a little bit to gender identity and autism specifically this is a topic which is certainly studied in the u.s. but a lot of the information we have that's relevant to autism in particular we get from the Netherlands and from Australia they have sort of bigger data sets over there and there's a couple of research groups that are really have some excellent work sort of constantly coming out of them so I'll introduce you to some of their results to sort of set the stage but definitely I would encourage you to go sort of look up some of these names afterward and on the last page of the or my last slide I do have the references so when the slides are posted you can take a look and do some exploring yourself so on this chart across the top you see a sign gender assigned sex at birth so male and female and down on the left you see how adults with autism are identifying now so they feel male this is their gender identity partly male partly not male or female don't know different feels female okay so what we're finding is that about 92% of autistic men in the Netherlands in this study say that they also feel like they are a man their gender identity is also male sort of consistent with their sex assigned at birth and then for females we see down on the bottom line that about 78% of females feel that their gender identity is also female okay these rates are significantly different from what we see in the neurotypical population with this particular study for generate nd they didn't have an exact comparison group but let me give you a few numbers to sort of help give you some context so they did a recent study it's just in 2018 that showed almost 3 percent of adolescents and I think was completed Minnesota identify as transgender or gender non-conforming right so that essentially not being female and feeling like female is also your gender identity which is a lot different than what we're seeing here so that would suggest that 97% of females also feel female and 97% of males also feel male so what we're noticing is that not necessarily that there are more males that think their gender identity is that they're a woman but that it's something other than the same gender identity and their sex assigned at birth which is the term we use for that is cisgendered when those sort of aligned with each other so right here we know that okay there's something that seems to be a little bit different for the autistic community that we should be aware of on the flip side they've done some interesting studies where they'll go into gender dysphoria clinics so these are clinics where people are experiencing a lot of stress about sort of this mismatch between the sex they were assigned at birth and their gender identity and in those groups we're seeing higher rates of autistic traits as well so there's there's something here that's been identified sort of over and over again in studies that's good for us to be aware of hmm with sexual orientation I actually did have the comparison group so we can look a little bit more directly so looking at whether people were autistic or neurotypical asking okay who do you feel attracted to and I'm not gonna go through this whole chart because it's a lot of numbers but the things that I'm gonna highlight are the little sections with stars some of the cherry-pick a little bit here so of the autistic men almost 82% said I'm attracted to women only right that that is it for the neurotypical group a little over 90 percent said that so there was a difference right there are more people more men with autism reporting sort other sexual orientations other than heterosexual and for women we saw that difference was even greater right so almost 50% of women said they were attracted to men only versus 87% of neurotypical adults being attracted to men early and then suppose women were falling sort of in other buckets so that this heterosexual framework for a relationship we don't see it quite as often in autism okay we don't know why that is we haven't done a lot to sort of dig into that I think that might be really interesting but I think what I will highlight in the next few slides is that uh we do have some work to do and some gaps to address because there is a certain amount of you know preparation for relationships that we would like to think we're including in our curriculum and training that we are not and it's particularly important to know that this is a population that needs that information because these are the relationships and generate entities that they are experiencing I will just highlight because I just think this is is particularly interesting is that more women if you notice the the rates more women generally identify as a sexual orientation other than heterosexual and that is true across autistic and neurotypical populations so with women in particular this is a good thing to be aware how we talk about and teach the concepts concepts of gender identity and sexual orientation is particularly critical for autistic learners and you're logged on so I'm assuming you probably already know this and if you don't by the time we get to the end of the hour I'm hoping you will be convinced I mean we just touched upon the fact that these concepts impact this population more than the neurotypical population right so obviously for that reason it's particularly critical um the second is really teaching about these khans sexual orientation and gender identity is not a mainstream component of sex education in this country so for most of the sex ed pieces today I'm gonna be talking about what we're doing or not doing in the u.s. and that's a problem that's something that we need to address and we'll we'll go through a couple of action steps to help with that and then third is really how we talk about gender identity gender and sexual orientation broadly tends to be a very rigid representation we rely a lot on gender stereotypes and if you are a learner who really likes things to have clear categories like some artistic learners are this idea of sort of non-binary identities or flexibility and identities could be challenging to teach then we don't have a lot of good guidance on how to do that especially if these really rigid rules are ingrained and society and like which toys were sold versus if you're a girl or a boy or which activities you're supposed to be doing and you know I've gotten questions before when we're talking about gender identity you know I had a young woman who said well you know I really like math and I really like sports so does that mean that I am a boy that my gender identity is right so parsing out with these different pieces and messages mean can be very interesting but a new a new challenge and then on the other hand I've had adults who are certainly aware that coming out as gay to their family may come out come with some social stigma you know coming out of a closet could be a big moment and there could be some challenge that but they feel less concerned with some of that stigma or less of that push to conform to quote-unquote gender norms and so in that way they find it really freeing so I think there's a whole range of experiences that people can have there's a lot of room for research and sort of clinical discussions about this but that it's really important that we we think about these issues as as parents as providers as individuals on the on the spectrum another reason right I'm a clinical psychologist so obviously there was going to be just a dash of mental health information thrown in here another reason this is important is because how mental health outcomes impact autistic individuals and then autistic individuals who have sort of non-heterosexual identities or non cisgendered identities is really critical so there's a lot of lines on this chart but really what this saying is personal well-being stress depression and anxiety and they measured each of these four autistic non-heterosexual and that is just a term to say gay lesbian bisexual pansexual asexual not just a heterosexual neurotypical non-heterosexual in neurotypical heterosexual so we find in these and no surprise to those of you in the SPARC community is that things like stress depression anxiety are higher for autistic folks okay this is in a study of adults for sexual orientation there wasn't a huge difference between for autistic individuals who were heterosexual or had some sort of other identity but there was a difference for the called gender dysphoria trait so these are differences between your sex assigned at birth and your gender identity so that autistic folks who were experiencing a gender identity that was different than their sex at birth were increasingly impacted by stress depression and anxiety and had lower ratings of personal well-being on to a significant level okay so that not only are artistic folks you know identifying with these identities more commonly than the neurotypical peers but when they do they're experiencing more negative mental health correlates with them and so we really need to make sure we're providing good resources because we already know the depression anxiety and stress is really hard and high for autistic adults and so this is just really a flag to us I think to be paying attention right that there's a lot of support that can be provided here which brings me to my other favorite soapbox right sexuality and relationship education you did register for this webinar so you probably knew this was coming but sexuality relationship Haitian in the US at least the structure can be really frustrating for many school-based programs there's sometimes the day for the sex talk some school says long have long as a semester or something have long as a year but it's really shockingly brief right if we think about other lifelong academic skills things like reading right you learn your letters you learn what they look like you learn their sounds then you build those into words you put words into sentences and then you learn how to write essays and PowerPoint presentations and things like that right and that is a lifetime skill that requires building on these smaller blocks it's really the same for sexuality and relationship education that you know we have the stereotype of this is one time oh you learn about s-cis and how you know how to prevent pregnancy when you're young there's so much more to it think about something like consent right that is a huge important topic and sexuality relationship education you know it's ISM and outside writing fur for anyone especially as you've been watching the news cycle the past few years but if you all Sundrop the idea of consent and how to to navigate consent into the lap of a teenager who's also navigating hormones and you know maybe wanting to be in a relationship or being nervous about being in a relationship and you haven't had those discussions leading up about boundaries on how to give consent in friendships over little things what are power dynamics what does it mean to feel safe and that's not going to make a lot of sense it's not really gonna stick right and you've missed out on a really huge teaching opportunity so how does this relate to sex and gender argue that it's really the same thing right you need to start small you need to start introducing kids to concepts when they're young so then when they start to think about their own identity they're a little bit prepared right they know sort of points what's going on so where are we now let me give you a little sort of lay of the land here in the US there's huge variation by state and then even beyond that by school okay I want you to think for a second about what should be covered in sex ed right this is a big topic people have a lot of different opinions on that what are some topics if you can think to yourself for a couple seconds that you think would be really important to include in any sort of sex ed experience my guess is that many of you touched on things like anatomy and physiology right like body parts but what what is going on what's when is puberty happening sexual health so a lot of you know sti's puberty and adolescent sexual development so how your body changes and then there are a couple of other areas that the that are in the National sex ed standards that I think are really important that sometimes get overlooked in or pretty relevant here gender identity and expression is right in there sexual orientation and identity is also in their consent in healthy relationships and interpersonal violence and the reason I highlight those four in particular is because those have a lot of social components in them and that is something that can be sort of more challenging to cover be sure that you cover when you're working with autistic learners another limitation that we have is the research tools to study these so some tools are updated especially when we think about gender identity and sexual orientation our understanding of these concepts has come a really long way in recent years but then it can be sort of hard to build on previous work because you don't want to use the same phrasing that was used before or that people don't really want to share this information right they're afraid if they participate in a study that information will be out and that can be really uncomfortable if they haven't come out to people you know and their family or in their community so that can be a limitation even for participating and really relevance to today's talk that sex ed programs in the US are geared toward heterosexual relationships so unmanned in a woman between cisgendered people so people whose sex assigned at birth is the same as their gender identity and we just saw that that's not as often the case in autism and this is true for over 90% of the sex ed programs in the u.s. currently okay so that's not great and then variable access for artistic learners and this is something that we've heard sort of over and over again that for some you know school-based program students might be included in the sex ed program but they might not have some of the learning adaptations that are available to them in other of their classes some might not be involved at all so there's a lot of room for improvement here about how we address access to sex ed for autistic students so what do we need to know how could we then improve upon these right now that I've gone and highlighted all of the issues that we have our teaching methods I won't go into this too much because this could be a whole sort of semester long course in them itself but there's a lot of innuendo when discussing sexuality right a lot of things are left unsaid we use words that sort of skip around and that social communication piece is missed a good example I like to think of here is when you think about sex education sometimes the classic example that comes to mind is like putting a condom on a banana right and certainly that is an important part of sexual health for sure but really at its core that's a motor task right and if you think about that in order to have gotten to that point in a relationship right you've had to identify someone that you might even need to use a condom with that you might want to have a relationship or sort of experience with you've had to flirt with them you've had to get them to call or text you back or you know like you back on tinder and then you've had to had that conversation about okay you know who's getting the condom are we using a condom you know why are we doing this what does it mean for us to be having sex there's so many social pieces that come before that where if you know how to put a condom on that's really maybe not the most useful part of that interaction to have to navigate sources of information right so how do we promote getting information from high quality sources so remember I mentioned the internet I'll get into that that can be great it can also give us some bad information so how do we make sure that we are coaxing people to get information from good quality places timing is a super interesting question about gender identity and sexual orientation in autism in particular first of all sex education in the u.s. is generally a bit too late right most sexually active teens get their first sex talk at school after they've had intercourse for the first time which isn't great so generally we need to move that whole timeline forward but beyond things like sexually seniors and puberty when we have a couple of rough estimates for things like figuring out your identity and and thinking through like how you might tell people about your identity or how you would even figure out what your identity is which is a big question I get in sex ed groups is how do these processes start are they the same for autistic adolescents and children as they are for neurotypical adolescents and children and that we really don't know we know from research with neurotypical kids that there's an awareness of gender before the age of two and that kids are pretty clear on their own assign gender and the characteristics that are associated by that by the time they're three so this starts very very young that's also when they're really aware of physical differences so they might be sort of playing doctor with their friends might be really interested in their own genitalia and then they are in this cognitive stage where they really like categories so they have this really rigid interpretation of girl stuff and boy stuff until they're about six okay so those are really firmly in place so is that the same in autism is that the timeline exactly the same if someone's developmental age is sort of closer to a five or six year old does that include that sort of interpretation of gender does that something that that shifts in terms of sexual orientation we know that regardless of identity and there are typical populations individuals retroactively a report they're sort of first sexual attraction around the age of nine or ten okay and that coincides with like things like the adrenal gland or maturing there's an increase in testosterone and things like that so it sort of makes sense medically why that would be happening and that depending on the culture kids with orientations other than heterosexual generally go through sort of a questioning period where they are processing their attraction to others figuring out what that means to them thinking about how that balances with cultural norms and is that process the same in autism and we really don't know that we haven't said much work on that at all and then obviously we need to know what would happen if we did have sex ed which was inclusive of all identities right I think this would be obviously great for people on the spectrum but also generally if over 90% of our gramming is geared toward people who are heterosexual insistent and we're missing a lot of kids in adolescence um and so you know we if we were to meet those needs how would that benefit the community so we're digging into some of these questions with work that we're doing in my research lab so we're doing an online anonymous study to sort of get at that you know if people weren't that comfortable sharing and we're asking both autistic and neurotypical adults a whole bunch of questions about their sex ed experiences what did you learn when did you learn when would you like to learn about certain topics relationship and identity experiences so similar like when were you first attracted to someone else when did you first think about your gender identity and then some commonly associated traits so things like anxiety depression repetitive behaviors to see how all of these factors are related to each other so for our first round that we complete in the fall we had 88 neurotypical adults and 44 autistic adults and then we'll be opening up at the end of summer to get another round of folks in and here's what we found I'm just going to highlight the findings that were relevant to the sort of gender identity and sexual orientation questions and we're still digging through the the rest of the data which has been a lot of fun so the first piece I want to share with you is timing right I was just like when do we teach about these things so to start we asked okay when did you first think about gender identity from your memory and when did you first think about sexual orientation and what we found is that there was no difference in the self-report between the autistic adults and the neurotypical adults the majority of people reported first thinking about either of these between the ages of 13 and 17 for gender identity about 10% said it first sort of occurred to them between the ages of 6 and 12 and then for sexual orientation about 21 percent so they first started thinking about sexual orientation between the ages of 6 and 12 so no difference though so the same so whatever timeline were teaching that on I think we should move it earlier generally right if you've got a fifth of kids thinking about this between the ages of 6 and 12 you know an eighth grade presentation on it it's going to be going to be too late and really not as helpful we also asked about sources of information so where are people getting information where kids getting information about different all sorts of different um sex ed topics but specifically about gender identity and sexual orientation and then we compared those between our artistic adults are not neurotypical adults and there are no differences again so people are using the same resources which is good news sort of it may not be a huge surprise but the internet was the biggest source of information for both topics right and we did break that down to ask about you know what sort of quality you know respected websites things like dot org websites right uh planned parenthood glad things like that and about seventy seven percent of people said that they were using sites like that they gave good information but over 65 percent said that they were also getting information from websites of unknown quality is sort of unverifiable which isn't great so some sort of sort of media awareness and literacy campaign I think is something we really should start thinking about in tandem with sex ed especially as people are thinking through their identities these are big questions you want to make sure they are relying on good information the other the third biggest source of information after quality website and unknown quality website was similar age peers so friends within two years at the age of the participant was the next biggest source of information about sexual orientation and gender identity and then a couple of numbers which I found a little less positive parents accounted for 16% of where people were getting information for gender identity and 11% for sexual orientation and then we down at the bottom we had 11 percent of people of respondents reported getting information on these topics from care providers so people like me like psychologists and doctors which i think is a real big call to make sure that we are asking those questions as providers because that should be a really great place to get information that we know is sort of safe and reliable we also asked folks across a range of sex ed topics okay what do you wish you had more about and this is where we did see a couple of differences significantly more often the autistic adults said sexual orientation and gender identity or topics I want more information about it was not as common in the neurotypical group so we're literally hearing from them now to sort of add to our list of why this is so critical this is something I want to hear more about which is good right so that's good you're at this talk you're already addressing this need and we also asked all the participants to compare their level of knowledge across a bunch of sex ed topics to their peers so you think you know the same amount more less a little more a little less than your peers across sexual orientation and gender identity for example and then we look to see how this was related to the autism quotient 10 which is a brief measure of self-report of autistic symptoms and we found there was no relationship with that either right so that people's perception of how much their peers know was not that impacted by whether or not they had autism so they're like okay I think these are sort of similar right my my peers know just as much or just as little as I do regardless of whether or not I'm on the spectrum so let me just summarize a couple of those those big points um and take homes that I want you to remember so gender identity diversity right and queer sexual orientations so non-heterosexual orientations occur more often in autistic populations than neurotypical populations then there's less access to sexuality and relationship education for autistic students and then finally that these programs in schools overwhelmingly do not include information that's relevant for the LGBTQ plus individuals which we know impacts the autistic group more than others and this is where I get to introduce you to one of my favorite television characters this is Eric if you have not had the pleasure of watching sex education on Netflix I would highly recommend his facial expressions are incredible but what right so we know there's this huge gap here that needs to be addressed this show was not autism focused but I really just thought he he captured my reaction to this the cluster of findings so what could we do about it and I think this is really the big meat and potatoes of why you're probably here today and I've broken this down into different groups that we'll talk about parents sort of other other adults and children side schools and then some experiences to make sure that year you're talking about um so first for parents I said start this early alright start talking about sexual orientation and gender identity right away I teach a sexuality and gender course at Tufts I'm in a child development child study in Human Development Department which means we get to spend a whole day looking at kids books and I can certainly send out a list of these as well I've got my I was able to snag some from my office before we closed but there's a whole bunch that they have they're geared toward little kids tango makes three read and these are sort of picture books but there's also little board books see is for consent is a really good one and so I and I have more recommendations here in case you are interested in knows but making sure that you are sort of offering and have available books in media with really diverse family structures and characters with various gender identities and you have to be pretty mindful about this this isn't a library that sort of going to curate itself right you have to dig a little bit but there's a lot of good reading list out there now that parents have found really helpful and then using wording like many or some we're discussing gender and sex right so instead of how boys have penises maybe like many boys have penises or some boys have penises because that gives you an opportunity to sort of discuss other gender identities and how you know genitalia might be different than someone's gender identity and why that might be and then finally reading up in identifying areas of discomfort and this is really a big one for school-based education sex education the biggest predictor of what you're taught is teacher comfort and then the resources that the school has available mhm for parents teaching sex ed it tends to be how we learn sex ed right and you can you know certainly think back on your own experience like how was gender identity discussed in your family how was sexual orientation discuss in your family and for many folks it just wasn't right and maybe for some of it was which would be great but if it wasn't then jumping into those conversations might be hard and so doing a little bit of prep work can be really helpful experts do recommend especially for autistic kids and adolescents that parents are really the most recommended source of sexuality relationship education which I think a lot of parents would agree with and they've done some really interesting studies about parent comfort with this so homes and Himmel did a really cool research study a few years ago and they asked parents okay what have you already told your teen about and what have you not told your teen about and what we're finding is that parents tend to avoid topics that they feel less comfortable with which makes sense but that leads kids to get information from less credible sources which we don't want so in this particular study bye-bye homes that I mentioned for teens on the spectrum with average or above-average IQ most parents cover topics or at home about things like privacy puberty sexual abuse prevention they do talk about family types and roles sort of like basic relationships would sort of get to that sexual orientation piece but they skip things like more relationships relevant questions right so general sexuality so things other than intercourse which tend to be pretty relevant for adolescent learners and then for parents of kids who had below average IQ similar patterns so really focusing on privacy sexual abuse prevention puberty which are super important but then not really talking about things like relationships sexuality and things like that in an on the resource page there will be a couple of links and books and things that could be particularly useful for parents that would be good to check out so other adults is my catch-all phrase for doctors or any sort of medical professionals oaties SLP psychologists social workers etcetera etcetera so other adults who are sort of coming in contact with with autistic learners the first is just to ask questions right so ask about gender identity and sexual orientation if it's not a typical part of your form on the intake process if you're out of practice change that leave a line pronouns right make it sort of a part of your practice so that kids that they want to share or if they have a question about something the the structure is already there that sort of removes one barrier to them asking questions having resources in your office and your waiting room so just have the stuff around right teens don't necessarily want to jump right in and ask you questions about sex and that's maybe you've had different experiences even as a sex educator that hasn't hasn't up in mine sometimes you got to sort of be like let's talk about it anyway even though it makes us uncomfortable but if you've got a book about gender on your bookshelf or you've got the gender unicorn sort of laminated hanging on your door that certainly opens the door and sends a good signal that you're ready for that conversation considering developmental age so this can be a really tricky one when we're talking about sexual maturation things like you know going through puberty those age sort of timelines don't differ that much between artistic and neurotypical populations with a lot of families that I work where they're like okay well my son has the body of a 17 year old but developmentally he's closer to a 9 or 10 year old so should I teach to the 17 year old body that he is or the 9 or 10 year old sort of understanding level that he's working on first rule of thumb is we always teach people for the body they have right so if you're 17 you've got to talk about a sort of work on 17 year old related topics things like masturbation right privacy boundary safety that sort of stuff and then appropriate way is to approach relationships as well but there's also really interesting chart in one of the books that I'll mention that talks about okay here are the developmental stages and here that's how you talk about topics things like gender right so if you've got a kid who sort of thinks like a five-year-old and they're in that very concrete rigid okay here's girl stuff and boy stuff how do you talk about gender identity with someone who's thinking like that so rely on your resources for that making sure you're sort of checking on both developmentally agent a lot of chronological age and then understanding family and community context this is extra important for gender identity and sexual orientation in particular you know this is I come at this from a very positive and sort of Buchman like oh let's let's talk about it and talk about how you're feeling and process this together that's not safe for all kids so especially if you are a provider and you're not sure if this is something that it'd be safe for a child to share at home that's good to assess for in the homeless adolescent and young adult population in the u.s. a huge percentage of those kids are LGBTQ plus because they have been kicked out of their homes when they came out to their families or communities so just to recognize that there there could be risk there and having conversations about how to come out if you want to come out who would be safe to come out to especially if there's a lot of social nuance involved in that could be really helpful to help a teen or a sort of a patient navigate so what to do at schools because this also comes a bit schools right identifying champions gonna be really good teachers are busy okay and especially after the spring that many of the schools around here have had your extra busy sort of Auslan sing you know your own kids balancing work at home and so I don't think this means that every teacher has to be a specialist and how to talk about sexual orientation and gender but have a few people or know that there's someone that you can go to who has good information to provide to students working sexuality relationship education into IEP so talking about gender identity sexual orientation consent all these things getting that sort of documented is how we approach that right into kids eye peas as early as you can as part of their sort of social and emotional learning and then focusing on behaviors in addition to discussing identity and it's could really have gone into any of the three boxes so far far um for some folks are like oh let's say you know I'm I'm a lesbian I know what that means and I know who I'm attracted to and that's a pretty clear-cut term for me for some vote folks either because of not wanting to be labeled or maybe there's a risk of being labeled they might not want to use it let's say they don't want to use the term lesbian but they will share with you that they have either romantic relationships or sexual experiences with other women right focusing on behaviors instead of the identity still gets the point across about what you're trying to talk about so if you are trying to talk about safes actual behaviors than dental dams for example it doesn't matter if you're a lesbian or not for that right what matters is that you're using safe sexual methods when you are having a sexual experience with a woman okay and so sometimes focusing on behaviors can be a good way to get around if someone is resistant to using certain terms and then supporting the Gay Straight Alliance or any sort of lgbtq+ group at your school there's another really good resource that talks about sexual orientation in the school setting and the number one way to reduce incidents of bullying is to have a group like this and have a lot of support for it so if there's not one talk about getting one started if there is one is there a way that you can support that group or you know do they have a sign you can hang in your classroom for many many students this is true or many groups this is true and so definitely explore what resources already exist at your school or institution or wherever you are and then just highlight a couple of experiences I think that cross a cross across all of these excuse me first keeping questions open-ended I think it's a pretty general women but instead of um do you like any boys at school right is there anyone that you like at school keeping that really open you know talking about examples of other people who have been in relationships with men or women or identify as non-binary and then navigating the coming-out process can be really challenging for neurotypical and autistic teens it's a very socially heavy interaction there's a lot of exciting food deciding when just being aware of that I think sort of offering like you want a brainstorm that can be really helpful if you especially for sort of verbal teams we're working through next steps and then also respecting and navigating if people don't want to come out right that that is an okay decision to make as well so the resource list the big excitement that people are here for a curricula so this is this is not an exhaustive list there are other ones out there the tackling teenage training program was developed in the Netherlands it is a one-on-one sex ed program that specifically covers sexual orientation and gender identity for autistic teens and this is not something that you can purchase but we are going to be running an online version of this starting later this summer and I'll tell you how to get in contact with us in case that is of interest but when you're looking for curricula to you know work with a teen or a younger person making sure that there are sections that are on sexual orientation and gender identity it starts or practicing that really early uh books there's a whole bunch of books um one that I think is particularly helpful either for individuals to read themselves or for parents to read it's called sex they all you need to know a sexuality guide to get you through your teens and 20s that is not autism specific but really introduced it has a lot of good chapters on gender identity and sexual orientation which is why I like to highlight it here the facts of life and more is geared toward individuals with developments of disabilities from broadly and this is really more for parents or providers they don't know if it would be as helpful for someone on the spectrum trait although maybe but it's geared toward folks who might have below average IQ and whose developmental level needs to be sort of factored in to how you're teaching about these different topics and then a guide to gender I like really accessible book to read it's got a little all gender restroom sign on the fact that you can use if you're in a place where you're able to shift something to an all gender bathroom and then the book that I mentioned I can classified sexual orientation gender identity and schooling talk specifically about how to support and sort of promote support of kids with different sexual orientations and gender identities in school settings it also has an international lens which is which is good couple of online quality resources they should have a term in there if you have not yet explored a sex ed for self-advocates through the Organization for autism research site go google it it's very cool it was developed with self advocates which i think is extra important there are videos there are different sections that you can navigate to so it always send people there always always glad is specifically geared towards sort of gay and lesbian resources um it's a very high quality site where you can get good information there's definitions of terms so if you're sort of starting to explore this process and wanting more information that can be a good jumping-off point and then Planned Parenthood has a number of videos and sort of educational resources there there are some that are specifically geared I think towards developmental disabilities more broadly but honestly they have a series of videos for their consent process um which I use in my groups all the time they show all sorts of different generate entities and relationship constellations and it really goes through okay what do you say in different situations to express consent to ask for consent and I really think it's it's just designed perfectly for someone with autism right so it really lays out those social communication steps and then the last three here television shows and I'm not saying that this should replace sex education or information about sexual orientation or gender identity but these can be really good places to start conversations especially for parents if you're like I think my child might want to talk about this I don't know how much they know how can we bring this up these can be a really good bridge sex education does not have any autistic characters or identified autistic characters in it but you will see a whole range of generated entities and sexual orientations in there and that's really for a teen audience and that's on Netflix everything's gonna be okay really heartwarming show this has the benefit of having a main character who is not only plays a artistic woman but she is arts issues an autistic actress herself so that's very cool and there's a lot of discussions about relationships and there and then a typical uh has been around for a little bit longer that's on Netflix that is about again a teenage boy who's on the spectrum he's starting to be interested in romantic relationships I'll take a quick second a brief little interesting history about a typical if you if you haven't seen it before the first season they had on Netflix got a little bit of her fair amount of pushback especially from self-advocates cuz they did not really integrate autistic voices at all as they should have and this was a group that took a pause you know brought autistic people into sort of the production process they now employ autistic actors as part of the show and they've done a really good job of sort of addressing some of the concerns the the community had about the show I will say that it does fall a little bit into that box of shows about sort of that Asperger profile upper class white boy navigating relationships so that is a little bit of a sort of downfall with that one but those are three really good places to start the talk about like education right in them and then for me oftentimes people have sort of questions are interested in studies in this area or during research themselves would be interested in collaborating it's a small community so definitely reach out if you're interested really the best way to keep in touch with us is we have accounts on Facebook Instagram and Twitter and it's under Korean lab I got really creative with this with the name anytime we have a new study going around we post on there we post resources about sex and post resources about books and self-advocates and that is also for better for worse because of COBIT all of our stays except for one are now online so you don't have to live in the Boston area near us to participate in them so keep an eye out for that they're mainly geared toward teens and adults and right now actually mostly choice at all but yeah if you are interested in those give us a follow and then when we post new study information there's always contact info there if you already know there's a study that you want to participate in Korean lab at tufts edu is right there for you to reach out to our team and then if you have other questions about like trainings or resources and things like that my email address is down there as well briefly and then i'll open up for questions for a couple minutes we actually are currently recruiting to build an advisory board i'm collaborating on a project with a group at BU where we're looking at how we even think about how we design sex ed programs so that would we're looking for autistic individuals between the ages of 16 and 25 who would be able to participate in eleven remote meetings per year you would be paid for your time you would be working with the advisory boards only about three to five people so it'll be small but that is coming up and then I have a couple of other projects over on the left of your screen if you're interested one on fitness that's an online interview siblings that's an online questionnaire and then our sex ed study that's gonna be online for teens and adults will be starting later this summer and then a second round of that study that I mentioned the results I mention a little bit earlier we will be opening that up in a few months so keep an eye out for that and I can pause there and if there are questions I would be happy to hear them thank you so much we did get a few questions and I think some of them were answered just just to remind everyone we will post the slides and a recording of this talk in the next few days so that will go up so let's hear someone has a question about how would you recommend talking to teens on the spectrum that identify as asexual or who may be uncomfortable even talking about sex yes I'm comfortable talking about sex if you like is the most common thing I talk about asexuality in the same way as we talk about any kind of sexuality like whatever feels like it's a good fit for you right now and it is totally fine inappropriate and I also try and normalize a little bit asexuality exists right um both in humans and in animals there's a great huge book it's called biological exuberance if you're ever interested talks about something like sexual orientation and different types of sexualities in the animal world which I use oftentimes in my class but yes so I normalize for sure and then I still and this is also true when I regardless of people's sexual orientation I really am a strong believer that people should hear all of the information about all of the identities because either you might get something out of it that you might not realize you might have a friend or family member who has different identity and then you have some background and things could shift over time right um you know if you're a asexual and then maybe you'll be asexual for the rest of your life or maybe right now someone's saying I'm a sexual but they're really and they don't want to be in a relationship that could shift later which would be different than identifying as asexual but yeah so I would I would address it directly normalize and then still provide of information just like any other sexual orientation thank you you mentioned a bunch of resources but do you have any that might be specific to adults with autism to guide on relationship education is there anything you'd recommend yeah that's a great question so the I would start with the sex ed for self-advocate that says sex in it but it is relationship focused for sure in terms of written resources I don't actually know anything off the top of my head that would be sort of like a like a self guide book I do Isabel penalty has a really good book it's called intimacy and Asperger's disorder I think like roughly the title it talks about building relationships that isn't all sexuality focused and then there's certainly some social skills programs which touch on building towards relationships like I know like the peers program the young adults version has a couple of chapters on dating yeah another one just came in about talking about non-binary identities I know you showed the chart at the beginning do you recommend anything else to to talk about non-binary identities so that um I'll actually go back for a second because I think it's called the trans student educational resource yes ts er um I will go trans to Norg and get there's also onion says transferring it's not just for people who are her transgender it has a whole bunch of resources on there so I would start there there's a lot of cool stuff on this site this is just one graphic that I usually pull okay what about someone that might have intellectual disability so maybe it could affect understanding about things like this the person we says masturbation how would you recommend kind of approaching that chocolate yeah that's a that's a great question um so for those I for those sorts of topics a couple of things one is I would pull on some of the one of the resources the the Walker Hirsch book in particular which maps some of the developmental stages onto behaviors I found that hugely helpful I think the second thing is to think about learning systems that have worked for your particular child or student before and then apply them to masturbation I think sometimes a little bit of a hit point can be like oh but it's about sex so like for example with masturbation if you've got someone who's pretty good at visuals using like blue dots or stickers or something to mark spots where you can masturbate right you just can't say don't masturbate all the time because people masturbate that's the thing right and so proactively and positively saying you can do it in here with your door closed if it you're you know in your bedroom or wherever you designated at home I mean that way if they start to do someplace else you can either pick like a different color or shape to say no this is no masturbating here but really making sure that you're pairing those so which would probably be a similar teaching device that you're using in other areas we're coming up on one o'clock but you are okay if people email you with additional questions I know we didn't get to everything so I do apologize but really thank you again